Interventions Targeting the Mental Health and Well-being of Care-Experienced Children and Young People: Mixed-Methods Systematic Review with Stakeholder Consultation to Inform Transportability and Adaptability to UK Context

Care-experienced children and young people are at increased risk of poor mental health and well-being, and suicide-related outcomes. There is an evidence-base for intervention effectiveness, but this is primarily from the USA. The present systematic review synthesised evidence for international interventions, exploring potential transportability and adaptability to the UK. We constructed an evidence map, and syntheses of intervention effectiveness, process evaluations and economic evaluations. We conducted seven stakeholder consultations with care-experienced young people, carers and professionals, to appraise transportability and adaptability. We identified sixty-four interventions, with 124 associated study reports. Seventy-seven were from the USA. There was limited effectiveness in targeting mental health, although there were promising approaches. Few approaches targeted well-being and suicide. Context factors, identified by the review and confirmed by stakeholders, may inhibit delivery: insufficient resources; time, emotional and cognitive burden; challenging interprofessional relationships; non-responsiveness to young people’s needs; and discounting of carers’ knowledge. Stakeholders recommended peer mentoring by other care-experienced individuals and system-change models that facilitate an attachment and/or trauma-informed ethos. Adaptation of existing approaches may be required to account for the context factors. Further intervention work is needed to target well-being and suicide.